The Child With a Neck Mass

Bernadette L. Koch, MD


Appl Radiol. 2005;34(8):8-22. 

In This Article


The majority of cystic neck masses in children are congenital. When midline or paramidline in position, thyroglossal duct cyst and dermoid cyst are the primary differential considerations. When off midline, branchial apparatus cysts and lymphatic malformations should be considered. Based on location and appearance, the majority of branchial apparatus cysts can be differentiated from lymphatic malformations.

Most solid neck masses in children are benign, including fibromatosis colli, in-flammatory adenopathy, hemangioma of infancy, neurofibroma, and benign teratoma. Using the clinical history, physical examination and imaging characteristics, most of these can be diagnosed with some certainty. Malignant lesions include lymphoma, rhabdomyosarcoma, neuroblastoma, and, rarely, metastatic adenopathy. Although it may be more difficult to make a definitive diagnosis in these children, with the above-mentioned imaging characteristics and clinical history, a reasonable differential diagnosis should be achievable.


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